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Ann Epidemiol. 2013 Jun;23(6):321-7. doi: 10.1016/j.annepidem.2013.03.010. Epub 2013 Apr 19.
Whole grains may offer protection from diabetes by decreasing energy intake, preventing weight gain, and direct effects on insulin resistance. This study examined associations of whole and refined grains with incident type 2 diabetes (T2D) ascertained by self-reported medication use in a cohort of postmenopausal women.
We included 72,215 women free of diabetes at baseline from the Women's Health Initiative Observational Study. Whole grain consumption was categorized as 0, less than 0.5, 0.5 to 1.0, 1.0 to less than 1.5, 1.5 to less than 2.0, and 2.0 or more servings per day. Proportional hazards regression was performed to estimate hazard ratios (HR) and 95% confidence intervals adjusting for potential confounders.
There were 3465 cases of incident T2D over median follow-up of 7.9 years. Adjusted for age and energy intake per day, successively increasing categories of whole grain consumption were associated with statistically significant reduced risk of incident T2D (HRs, 1.00, 0.83, 0.73, 0.69, 0.61, and 0.57; P for trend < 0.0001). Results were attenuated after adjustment for confounders and other dietary components. The reduction in risk of T2D was greater among nonsmokers and those who maintained their weight within 5 pounds with higher consumption of whole grains than smokers and women who gained more weight.
This large, prospective study found an inverse dose-response relationship between whole grain consumption and incident T2D in postmenopausal women.
全谷物可能通过减少能量摄入、防止体重增加以及对胰岛素抵抗的直接影响，提供对糖尿病的保护。本研究通过自我报告药物使用，在一项绝经后妇女队列中，检查了全谷物和精制谷物与 2 型糖尿病（T2D）发病的关联。
我们纳入了来自妇女健康倡议观察研究的 72215 名基线无糖尿病的女性。全谷物摄入量分为 0、<0.5、0.5-1.0、1.0-<1.5、1.5-<2.0 和每天 2.0 份或以上。采用比例风险回归估计风险比（HR）和 95%置信区间，调整潜在混杂因素。
在中位随访 7.9 年期间，共发生 3465 例 T2D 事件。调整年龄和每日能量摄入后，连续增加的全谷物摄入量类别与 T2D 发病风险显著降低相关（HRs，1.00、0.83、0.73、0.69、0.61 和 0.57；趋势 P<0.0001）。调整混杂因素和其他饮食成分后，结果减弱。与吸烟者和体重增加较多的女性相比，全谷物摄入量较高的不吸烟者和体重波动在 5 磅内的女性 T2D 发病风险降低幅度更大。
这项大型前瞻性研究发现，绝经后妇女全谷物摄入量与 T2D 发病呈负相关剂量反应关系。
